Evidence map›Paper›PMID 23100499›Full record

SynthesisThe European respiratory journal2013

Resistance to fluoroquinolones and second-line injectable drugs: impact on multidrug-resistant TB outcomes.

Dennis Falzon, Neel Gandhi, Giovanni B Migliori, Giovanni Sotgiu, Helen S Cox, Timothy H Holtz, Maria-Graciela Hollm-Delgado, Salmaan Keshavjee, Kathryn DeRiemer, Rosella Centis and 5 more

Registry-linked trialOpen access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The European respiratory journal, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06590428 (Therapeutic Drug Monitoring for Linezolid in the Treatment of Rifampin-resistant Tuberculosis), which is not on this map. Cited by 147 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
147citing papers in PubMed, 10 pooled it
20.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06590428 narecruitingnot on this mapstarted 2026, after this paper: background citation

Therapeutic Drug Monitoring for Linezolid in the Treatment of Rifampin-resistant Tuberculosis

TypeinterventionalSponsorAlbert Einstein College of MedicineRan2026 to 2029Enrolled280ConditionsRifampin-resistant Tuberculosis, Drug-resistant TuberculosisArmsTherapeutic Drug Monitoring for Linezolid
3 · Its place in the literature

Who cites it

147 citing papers in PubMed, 10 syntheses or guidelines pooled it, 379 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2019
    Guideline
  4. Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews.European respiratory review : an official journal of the European Respiratory Society · 2019
    Pooled it
  5. Pooled it
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  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Trial
  12. Trial
  13. Trial
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  15. Article
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  17. Review
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87 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 8 countries.

Dennis FalzonStop TB Dept, World Health Organization, Geneva, Switzerland.
Neel Gandhi
Giovanni B Migliori
Giovanni Sotgiu
Helen S Cox
Timothy H Holtz
Maria-Graciela Hollm-Delgado
Salmaan Keshavjee
Kathryn DeRiemer
Rosella Centis
Lia D'Ambrosio
Christoph G Lange
Melissa Bauer
Dick Menzies
Collaborative Group for Meta-Analysis of Individual Patient Data in MDR-TB
American College of Chest Physicians · USWorld Health Organization - Italy · ITAlbert Einstein College of Medicine · USCenters for Disease Control and Prevention · UGHarvard University · USMédecins Sans Frontières · ZAResearch Center Borstel - Leibniz Lung Center · DEUniversity of California, Davis · USUniversity of Sassari · ITWorld Health Organization · CH

Funding

Impact of HIV, Antiretroviral Therapy and TB Genotype on Survival in MDR TBR01AI087465 · NIAID · EMORY UNIVERSITY · PI GANDHI, NEEL RAJNIKANT · 2010 to 2014
$3.9M
Transmission of HIV-Associated XDR TB in Rural South AfricaR01AI089349 · NIAID · EMORY UNIVERSITY · PI GANDHI, NEEL RAJNIKANT · 2010 to 2014
$3.7M
Transmission and virulence of Mycobacterium tuberculosisDP2OD006452 · OD · UNIVERSITY OF CALIFORNIA AT DAVIS · PI DERIEMER, KATHRYN L · 2010 to 2010
$2.3M
Molecular vs Conventional Assessment of TB TransmissionK01TW000001 · FIC · UNIVERSITY OF CALIFORNIA DAVIS · PI DERIEMER, KATHRYN · 1999 to 2004
$550k
CIHRFIC NIH HHS K01 TW000001FIC NIH HHS K01TW000001Howard Hughes Medical Institute 55000632NIAID NIH HHS R01 AI087465NIAID NIH HHS R01 AI089349NIH HHS DP2 OD006452PHS HHS A135969Wellcome TrustWellcome Trust 176W009
6 · The paper itself

Abstract

A meta-analysis for response to treatment was undertaken using individual data of multidrug-resistant tuberculosis (MDR-TB) (resistance to isoniazid and rifampicin) patients from 26 centres. The analysis assessed the impact of additional resistance to fluoroquinolones and/or second-line injectable drugs on treatment outcome. Compared with treatment failure, relapse and death, treatment success was higher in MDR-TB patients infected with strains without additional resistance (n=4763; 64%, 95% CI 57-72%) or with resistance to second-line injectable drugs only (n=1130; 56%, 95% CI 45-66%), than in those having resistance to fluoroquinolones alone (n=426; 48%, 95% CI 36-60%) or to fluoroquinolones plus second-line injectable drugs (extensively drug resistant (XDR)-TB) (n=405; 40%, 95% CI 27-53%). In XDR-TB patients, treatment success was highest if at least six drugs were used in the intensive phase (adjusted OR 4.9, 95% CI 1.4-16.6; reference fewer than three drugs) and four in the continuation phase (OR 6.1, 95% CI 1.4-26.3). The odds of success in XDR-TB patients was maximised when the intensive phase reached 6.6-9.0 months duration and the total duration of treatment 20.1-25.0 months. In XDR-TB patients, regimens containing more drugs than those recommended in MDR-TB but given for a similar duration were associated with the highest odds of success. All data were from observational studies and methodologies varied between centres, therefore, the bias may be substantial. Better quality evidence is needed to optimise regimens.

Indexed as

Drug Resistance, BacterialAnti-Bacterial AgentsAntitubercular AgentsData CollectionFluoroquinolonesHumansMycobacterium tuberculosisObservational Studies as TopicTreatment FailureTreatment OutcomeTuberculosis, Multidrug-ResistantAnti-Bacterial AgentsAntitubercular AgentsFluoroquinolones

Identifiers

PMID23100499
PMCPMC4487776
OpenAlexW2156941948

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.